Individual
RAE JEAN JESSEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
927 KENTON STATION DR, MAYSVILLE, KY 41056-9617
(606) 759-0433
(606) 759-0058
Mailing address
PO BOX 550, VANCEBURG, KY 41179-0550
(606) 796-3029
(606) 796-6221
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3003558
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7100062190
GROUP NURSE PRACTITIONER MEDICAID NUMBER
KY
05
—
78011772
—
KY
Enumeration date
09/16/2005
Last updated
03/25/2014
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